What is a Vertical Expandable Prosthetic Titanium Rib (VEPTR)?

The Vertical Expandable Prosthetic Titanium Rib (VEPTR) is the only FDA-approved device to treat thoracic insufficiency syndrome (TIS) in children. This is a congenital condition (present from birth) in which severe deformities of the chest, spine, and ribs inhibit normal lung growth, development, and the ability to breathe. The VEPTR is a curved metal rod surgically attached to the patient’s ribs, spine, or pelvis using hooks on both ends of the device. The purpose of VEPTR is to straighten the child’s spine so their lungs can grow and expand as they grow. The VEPTR can be expanded or contracted by the child’s doctor as the child grows.

The purpose of VEPTR is to:

  • Allow for more normal growth patterns
  • Decrease deformities of the thorax
  • Decrease the need for supplemental oxygen
  • Expand the volume of the lungs
  • Improve the capability to perform physical activities
  • Better psychosocial health

Dr. Melvin Smith, a pediatric general surgeon, and Dr. Robert M. Campbell Jr. implanted the first titanium rib into a child in Texas in 1989. Over the years, the procedure has been refined and modified, and in 2004, the U.S. Food and Drug Administration (FDA) approved VEPTR as a medical device under the Humanitarian Device Exemption Program. These are devices intended to treat rare diseases or conditions.

What Is Thoracic Insufficiency Syndrome?

Children with TIS cannot breathe normally because of thorax (spine, ribcage, and breastbone) abnormalities caused by problems in how the chest and spine developed. Treatment options for this condition are limited. The placement of a titanium rib can help a child with TIS breathe more comfortably and it allows for more normal growth of the thorax. Most children have the operation before they turn 5 years old.

What to Expect During VEPTR Surgery

During the VEPTR operation, a pediatric orthopedic surgeon attaches and adjusts the VEPTR device vertically to the child’s ribs near their spine. Sometimes more than one device is needed to create space in the chest for the lungs to develop properly.

What to Expect After VEPTR Surgery

Your child will continue to heal upon discharge from the hospital. A follow-up visit with their pediatric orthopedic surgeon will be necessary to check the incision sites.

VEPTR adjustment surgery will be required as your child grows and is typically done every 6 to 9 months until your child is fully grown and reaches skeletal maturity between the ages of 10 and 16. The surgery is necessary to expand the VEPTR device during periods of rapid growth. VEPTR may be combined with other surgical treatments, such as MAGEC or other growing rods to ensure your child continues to develop on target.

What to Expect After VEPTR Surgery

Generally, long-term outcomes after VEPTR surgery are good. Once a child reaches skeletal maturity, the care team may recommend spinal fusion surgery so the spine and chest corrections will be permanent. Some children keep the VEPTR device indefinitely, particularly if they have missing or fused ribs.

Patient Stories

  • It was hard being in the hospital for so long, but we were grateful that CSH allowed parents to stay. The hospital had a family lounge, game nights, and lots of ways to keep the parents informed. We had weekly meetings with his care team and received daily ...

    Patrick
    Read More
  • “The recovery was pretty challenging. But in my head, I was like, ‘I need to do this if I still want to play football in college.’ So I pushed through it, and in the end, it all came out amazing.”

    Hunter
    Read More
  • “I feel amazing. I can move. I can do so much more physical activity without feeling pain.”

    Cheyanne
    Read More

Patient Stories

  • Watch Testimonial
  • Watch Testimonial
  • Watch Testimonial
Cooperman Barnabas Medical Center
94 Old Short Hills Road
Livingston, NJ 07039
(973) 322-5000
View
Clara Maass Medical Center
1 Clara Maass Drive
Belleville, NJ 07109
(973) 450-2000
View
Community Medical Center
99 Highway 37 West
Toms River, NJ 08755
(732) 557-8000
View
Children's Hospital of New Jersey at Newark Beth Israel Medical Center
201 Lyons Avenue at Osborne Terrace
Newark, NJ 07112
(973) 926-7000
View
Jersey City Medical Center
355 Grand Street
Jersey City, NJ 07302
(201) 915-2000
View
The Bristol-Myers Squibb Children's Hospital at RWJUH
200 Somerset Street
New Brunswick, NJ 08901
(732) 828-3000
View
RWJ University Hospital Rahway
865 Stone Street
Rahway, NJ 07065
(732) 381-4200
View
The Unterberg Children's Hospital at Monmouth Medical Center
300 2nd Avenue
Long Branch, NJ 07740
(732) 923-7250
View
RWJ University Hospital Hamilton
1 Hamilton Health Place
Hamilton, NJ 08690
(609) 586-7900
View
Robert Wood Johnson University Hospital
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
(732) 828-3000
View
Children's Specialized Hospital Outpatient Center – Clifton
1135 Broad Street
Clifton, NJ 07013
(973) 365-3071
View
Children's Specialized Hospital Outpatient Center – Union
2840 Morris Avenue
Kenneth Esdale Pavilion
Union, NJ 07083
(888) 244-5373
View

Orthopedics - Pediatric Treatment & Care

offered at these locations in your neighborhood

View All Locations